Commonly known as "pinkeye" because of the inflamed tissues that are seen when the eyelid is pulled back, conjunctivitis is the most common infectious disease of the eye that affects children. Although most types of conjunctivitis are contagious, it usually causes no danger to the eye. Besides infections, conjunctivitis can also be caused by inflammation or irritants to the eye.
The first symptom of conjunctivitis is discomfort in the eye, followed by redness and inflammation of the conjunctiva, the tissue covering the eye and inner surface of the eyelids. There is some pain associated with conjunctivitis, but your child will probably complain mostly of discomfort that is not relieved by rubbing or the sensation of something that feels like sand in the eye.
After a day or so of these symptoms, a white, yellow, or green discharge from the eyes may be present. In bacterial conjunctivitis, the discharge will be somewhat thick. In viral conjunctivitis, the discharge may be thinner, and may even be clear.
Most conditions in the adult are secondary to staphylococcus (staph) or streptococcus (strep) infections. If the discharge is severe, gonococcal (gonorrhea) conjunctivitis must be considered. In children, the bacteria known as Hemophilus influenza may be present. This bacterial infection is not related to the common flu, which is viral in nature. Newborn infants with conjunctivitis must be evaluated for gonococcal and chlamydia conjunctivitis (sexually transmitted diseases), however, staphylococcus, streptococcus, and other infectious agents must be considered as well.
Neonatal and adult inclusion conjunctivitis result from exposure to infected genital secretions. It is transmitted to the eye at birth or by fingers and occasionally by the water in swimming pools, poorly chlorinated hot tubs, or by sharing makeup. In adult inclusion conjunctivitis, one eye is usually involved, with a stringy discharge of mucus and pus. There may be little bumps called follicles inside the lower eyelid and the eye is red. Occasionally, the condition damages the cornea, causing cloudy areas and a growth of new blood vessels.
In most cases of adult or childhood conjunctivitis, treatment with topical antibiotics is initiated without cultures. If the ophthalmologist elects for cultures, antibiotic therapy is usually initiated and treatment changed later, as necessary, depending on culture results. Gonococcal conjunctivitis requires intravenous or intramuscular antibiotics in addition to topical therapy.